|Número de publicación||US8920429 B2|
|Tipo de publicación||Concesión|
|Número de solicitud||US 13/836,621|
|Fecha de publicación||30 Dic 2014|
|Fecha de presentación||15 Mar 2013|
|Fecha de prioridad||7 Jun 2004|
|También publicado como||CN102525659A, CN102525659B, EP1768543A2, EP1768543B1, EP2992808A1, US7828808, US8419747, US9517326, US20050273084, US20100249759, US20130218141, US20150119903, WO2005120327A2, WO2005120327A3|
|Número de publicación||13836621, 836621, US 8920429 B2, US 8920429B2, US-B2-8920429, US8920429 B2, US8920429B2|
|Inventores||Cameron D. Hinman, David J. Danitz|
|Cesionario original||Intuitive Surgical Operations, Inc.|
|Exportar cita||BiBTeX, EndNote, RefMan|
|Citas de patentes (193), Otras citas (25), Citada por (1), Clasificaciones (25)|
|Enlaces externos: USPTO, Cesión de USPTO, Espacenet|
This application is a continuation application Ser. No. 12/816,359, entitled LINK SYSTEMS AND ARTICULATION MECHANISMS FOR REMOTE MANIPULATION OF SURGICAL OF DIAGNOSTIC TOOLS, filed Jun. 15, 2010, now U.S. Pat. No. 8,419,747, which is a continuation of application Ser. No. 10/928,479, entitled, LINK SYSTEMS AND ARTICULATION MECHANISMS FOR REMOTE MANIPULATION OF SURGICAL OF DIAGNOSTIC TOOLS, filed Aug. 26, 2004 now U.S. Pat. No. 7,828,808 which claims priority to Application No. 60/577,757, entitled, ARTICULATING MECHANISM WITH FLEX-HINGED LINKS, filed Jun. 7, 2004, the contents of which are hereby incorporated by reference into the present disclosure.
This invention relates to link systems and applications thereof, including the remote guidance and manipulation of surgical or diagnostic instruments and tools.
The ability to easily remotely steer, guide and/or manipulate instruments and tools is of interest in a wide variety of industries and applications, in particular where it is desired to navigate an instrument or tool into a workspace that is not easy to manually navigate by hand or that might otherwise present a risk or danger. These can include situations where the targeted site for the application of a tool or instrument is difficult to access, e.g. certain surgical procedures, or the manufacture or repair of machinery, or even commercial and household uses, where manual access to a targeted site is restricted or otherwise. Other situations can include e.g. industrial applications where the work environment is dangerous to the user, for example, workspaces exposed to dangerous chemicals. Still other situations can include e.g. law enforcement or military applications where the user may be at risk, such as deployment of a tool or instrument into a dangerous or hostile location.
Using surgical procedures as an illustrative example, procedures such as endoscopy and laparoscopy typically employ instruments that are steered within or towards a target organ or tissue from a position outside the body. Examples of endoscopic procedures include sigmoidoscopy, colonoscopy, esophagogastroduodenoscopy, and bronchoscopy. Traditionally, the insertion tube of an endoscope is advanced by pushing it forward, and retracted by pulling it back. The tip of the tube may be directed by twisting and general up/down and left/right movements. Oftentimes, this limited range of motion makes it difficult to negotiate acute angles (e.g., in the rectosigmoid colon), creating patient discomfort and increasing the risk of trauma to surrounding tissues. Laparoscopy involves the placement of trocar ports according to anatomical landmarks. The number of ports usually varies with the intended procedure and number of instruments required to obtain satisfactory tissue mobilization and exposure of the operative field. Although there are many benefits of laparoscopic surgery, e.g., less postoperative pain, early mobilization, and decreased adhesion formation, it is often difficult to achieve optimal retraction of organs and maneuverability of conventional instruments through laparoscopic ports. In some cases, these deficiencies may lead to increased operative time or imprecise placement of components such as staples and sutures. Steerable catheters are also well known for both diagnostic and therapeutic applications. Similar to endoscopes, such catheters include tips that can be directed in generally limited ranges of motion to navigate a patient's vasculature.
There have been many attempts to design endoscopes and catheters with improved steerability. For example, U.S. Pat. No. 3,557,780 to Sato; U.S. Pat. No. 5,271,381 to Ailinger et al.; U.S. Pat. No. 5,916,146 to Alotta et al.; and U.S. Pat. No. 6,270,453 to Sakai describe endoscopic instruments with one or more flexible portions that may be bent by actuation of a single set of wires. The wires are actuated from the proximal end of the instrument by rotating pinions (Sato), manipulating knobs (Ailinger et al.), a steerable arm (Alotta et al.), or by a pulley mechanism (Sato). U.S. Pat. No. 5,916,147 to Boury et al. discloses a steerable catheter having four wires that run within the catheter wall. Each wire terminates at a different part of the catheter. The proximal end of the wires extend loosely from the catheter so that the physician may pull them. The physician is able to shape and thereby steer the catheter by selectively placing the wires under tension.
Although each of the devices described above are remotely steerable, their range of motion is generally limited. The steering mechanisms may also be laborious to use, such as in the catheter of Boury et al. where each wire must be separately pulled to shape the catheter. Further, in the case of e.g. endoscopes and steerable catheters that use knob and pulley mechanisms, it requires a significant amount of training to become proficient in maneuvering the device through a patient's anatomy.
Consequently, a device with enhanced remote maneuverability to controllably navigate complex geometries may allow more efficient and precise advancement and deployment of instruments and tools. It would also be advantageous for such a device to provide a more intuitive and facile user interface to achieve such enhanced maneuverability. It would be further advantageous for such a device to limit undesired tension or slack in cable components. In addition, it would be advantageous for such a device to have a locking mechanism capable of preventing movement of the device. Such a device would have widespread application in guiding, steering and/or manipulating instruments and tools across numerous industries. Such a device would also of itself have entertainment, recreation and educational value.
The present invention provides for articulating mechanisms, link systems, and components thereof, useful for a variety of purposes including, but not limited to, the remote manipulation of instruments such as surgical or diagnostic instruments or tools. Such instruments and tools can include surgical or diagnostic instruments or tools, including but not limited to endoscopes, catheters, Doppler flow meters, microphones, probes, retractors, dissectors, staplers, clamps, graspers, scissors or cutters, ablation or cauterizing elements, and the like. Other instruments or tools in non-surgical applications include but are not limited to graspers, drivers, power tools, welders, magnets, optical lenses and viewers, electrical tools, audio/visual tools, lasers, monitors, and the like. Depending on the application, it is contemplated that the articulating mechanisms, link systems, and other components of the present invention can be readily scaled to accommodate the incorporation of or adaptation to numerous instruments and tools. The link systems and articulating mechanism may be used to steer these instruments or tools to a desired target site, and can further be employed to actuate or facilitate actuation of such instruments and tools.
In one aspect of the invention, a link system is provided that includes a plurality of links, wherein at least two adjacent links are pivotable relative to one another about two distinct pivot points. In certain variations the adjacent links have opposing surfaces with each surface having an axially aligned convex protrusion or concave depression. In such variations, the link system further includes a bushing interposed between at least two adjacent links, the bushing contacting the convex protrusion or concave depression of each of the at least two adjacent links. The bushing may include a concave depression or convex protrusion configured to receive an opposing convex protrusion and/or concave depression of the adjacent links. In some instances, the convex protrusion or concave depression of adjacent links is hemispherical. Such link systems can be incorporated into or otherwise form components of articulating mechanisms according to the invention.
In another aspect of the invention, an articulating mechanism is provided for, e.g., remote manipulation of a surgical or diagnostic tool. The articulating mechanism can include one or more link systems that allow for remote manipulation of a distally located tool or instrument. In one variation, an articulating mechanism is provided that includes multiple pairs of links, each link being maintained in a spaced apart relationship relative to the other link of the pair. At least two adjacent links are pivotable relative to one another about two distinct pivot points. In certain variations the adjacent links have opposing surfaces each have an axially aligned convex protrusion or concave depression, and are separated by a bushing interposed therebetween. The articulating mechanism further includes multiple sets of cables, each set connecting the links of a discrete pair to one another such that movement of one link of a pair causes corresponding relative movement of the other link of the pair. In certain variations, the links are designed to reduce or eliminate excess cable slack or tension between adjacent links.
In a further aspect of the invention, a locking mechanism is provided that may be incorporated into an articulating mechanism. The mechanism is configured to receive one or more cables (or other actuating elements) distally connected to one or more links and, when activated, impede movement of the cables (or other actuating elements) thus impeding movement of the corresponding links themselves. In one embodiment of the locking mechanism, the mechanism is configured such that each cable is able to pass between a moveable locking member and a fixed contact member. Movement of the moveable locking member causes one or more cables to contact the fixed contact member thereby frictionally impeding the movement of one or more cables.
In another embodiment, the locking mechanism can include one or more locking channels positioned perpendicular to the central axis of the locking mechanism. A moveable button member is positioned in each of the one or more locking channels within the mechanism housing. The housing can include one or more through-channels that receive one or more cables (or other actuating elements), with each locking channel associated with each through-channel. Depression of the button member within the locking channel brings a cable (or other actuation elements) in an associated through-channel into frictional contact with the cylinder, thereby frictionally impeding movement of the cable.
In another embodiment, the locking mechanism includes a dual collar mechanism having axially aligned fixed and moveable collars. One or more cable sets (or other actuation elements) pass through one collar and around the perimeter of the other collar. Axial movement of the moveable collar towards the fixed collar brings the cables into contact with both collars, thereby frictionally impeding movement of the cables.
In a further aspect of the invention, a surgical device is provided that includes a surgical or diagnostic tool and a plurality of links proximal of the surgical or diagnostic tool. An elongate shaft is proximal of the plurality of links, and one or more cables are distally connected to one or more links and received proximally through the elongate shaft. Movement of one or more cables causes movement of one or more links. Again, at least two adjacent links are pivotable relative to one another about two distinct pivot points. In certain variations, at least two of the adjacent links have opposing surfaces with an axially aligned convex protrusion and/or concave depression and are separated by a bushing interposed therebetween. The bushing contacts the convex protrusion or concave depression of each of the adjacent links.
In further aspects of the invention, a tool or instrument may be attached to and extend from the link systems and/or articulating mechanisms, or the link systems and/or articulating mechanisms may be otherwise incorporated into such instruments or tools. In the case of surgical applications, examples of surgical or diagnostic tools include, but are not limited to, endoscopes, catheters, Doppler flow meters, microphones, probes, retractors, dissectors, staplers, clamps, graspers, scissors or cutters, and ablation or cauterizing elements. For other applications, numerous tools or instruments are likewise contemplated, including without limitation, e.g., graspers, drivers, power tools, welders, magnets, optical lenses and viewers, light sources, electrical tools, audio/visual tools, lasers, monitors, and the like. The types of tools or instruments, methods and locations of attachment, and applications and uses include, but are not limited to, those described in pending and commonly owned U.S. application Ser. No. 10/444,769, incorporated herein by reference in its entirety.
As further detailed herein, articulating link systems and mechanisms are provided that can form, or be incorporated into, or otherwise constitute a wide variety of devices. The link systems may be made from a combination of individual links. Articulating mechanisms according to the invention generally include multiple pairs of links and at least one set of cables connecting at least one discrete pair of links. The term “link” as used herein refers to a discrete portion of a link system or articulating mechanism that is capable of movement relative to another discrete portion of the mechanism or system. In some embodiments, the link may correspond to another discrete portion or defined area at the opposite end of the mechanism. Links are typically, but need not be, cylindrical. The links are generally aligned along the longitudinal axis of the mechanism. In certain embodiments, the link systems will include a plurality of links, at least two of which are separated by a bushing.
The link systems can form or be incorporated into a variety of articulating mechanisms. In various embodiments, articulating mechanisms according to the invention generally include multiple pairs of links and multiple sets of cables. In further embodiments, the articulating mechanism includes a plurality of links or segments that are members of discrete pairs. The links form a proximal end and a distal end, with one link of each pair being situated in a link system at the proximal end, and the other link of the link pair in a link system at the distal end.
In such articulating mechanisms, each cable set connects the links of a discrete pair in the articulating mechanism to one another so that movement of one link of a pair causes a corresponding movement of the other link in the pair. As used herein, the term “active link” or “active link pair” refers to links that are directly connected to one another by a cable set. The term “spacer link” or “spacer link pair” refers to links that are not directly connected by a cable set. Spacer links can nevertheless be disposed between active links and provide for the passage of cable sets that connect active link. The ability to manipulate active link pairs allows for the mechanism to readily form complex three-dimensional configurations and geometries as is further detailed herein. With conventional articulating devices that rely on cable sets or wires that pass through otherwise unconnected links, it is difficult to obtain such complex geometries because such devices are typically designed such that the steering cables or wires pass through each link and terminate at a distal-most link. Thus, all the segments bend together in a coordinated response to movement of the wire or cable set, typically in a curved, or arcuate fashion.
The link systems or articulating mechanisms of the present invention may, for example, be incorporated into devices used to direct and steer a surgical or diagnostic instrument tool to a target site within a body region of a patient. The device can be introduced either in its native, straight configuration, or after undergoing various manipulations at its proximal end from a location outside the patient. In various embodiments, link systems form a part or parts of an articulating mechanism. Movement of the proximal end of the mechanism, results in movement at the distal end. Further, the resulting directional movement of the distal end can be inverted, mirrored or otherwise, depending on the degree of rotation of the proximal end relative to the distal end. Also, the proximal end provides for a user interface to control the steering and manipulation of the distal end that is convenient and easy to use. This user interface allows for example a user to readily visualize the shape and directional movement of distal end of the mechanism that is located e.g. within a patient based on the manipulated shape of the externally positioned proximal end user interface. Alternatively, control or actuation of the distal end links can be accomplished by more conventional methods of manipulating the link actuating cables, e.g., through the use of knob and pulley systems and the like.
In addition to the formation of complex configurations, the present invention also allows for increased rigidity of the mechanism by constraining manipulated active links and allowing such links to resist movement due to laterally applied forces. A given link pair is considered fully constrained if upon manipulating the links to achieve the desired shape, and fixing one link of the pair in that desired shape, the other link of the pair can resist loads while maintaining its desired, unloaded shape. For links that are otherwise free to move in three degrees of freedom, a minimum of three cables are required to fully constrain the links. This is not always the case with conventional articulating devices. Spacer links will not be so constrained, and the inclusion of such unconstrained links may be advantageous in many situations where it is desirable to have portions of the actuated mechanism be less rigid.
The terms “instrument” and “tool” are herein used interchangeably and refer to devices that are usually handled by a user to accomplish a specific purpose. For purposes of illustration only, link systems and articulating mechanisms of the invention will be described in the context of use for the remote guidance, manipulation and/or actuation of surgical or diagnostic tools and instruments in remote accessed regions of the body. As previously noted, other applications of the link systems and articulating mechanisms besides surgical or diagnostic applications are also contemplated and will be apparent to one of skill in the art. Generally any such application will include any situation where it is desirable to navigate an instrument or tool into a workspace that is not easy to manually navigate by hand or that might otherwise present a risk or danger. These include, without limitation, industrial uses, such as for the navigation of a tool, probe, sensor, etc. into a constricted space, or for precise manipulation of a tool remotely, for example, for the assembly or repair of machinery. These can also include commercial and household situations where the targeted site for the application of a tool or instrument is difficult to access. Other situations can include e.g. industrial applications where the work environment is dangerous to the user, for example, workspaces exposed to dangerous chemicals. Still other situations can include e.g. law enforcement or military applications where the user may be at risk, such as deployment of a tool or instrument into a dangerous or hostile location. Yet other uses include applications where simply remote manipulation of complex geometries is desirable. These include uses in recreation or entertainment, such as toys or games, e.g., for remote manipulations of puppets, dolls, figurines, and the like.
With reference to
As depicted in greater detail in
Handle 110 of driver 100 is a conventional ratchet-style handle that is operably linked to actuating cable 148. In particular, as shown in
As most clearly shown in
In various embodiments of the invention, the link sets or link systems are designed to have “neutral cable bias” based on the configuration of each link and bushing. When a link system bends due to an actuating force applied by a cable or cables along one side of the links, the relative tautness of cables passing through the links can be affected in a positive, negative or neutral manner. This effect, or bias, can also be referred to as “cable pull bias.” Link systems that create or increase cable tension when the links are articulated are said to have “positive bias.” Alternatively, link systems that result in decreased cable tension or slack when the links are articulated are referred to as having a “negative bias.” Link systems that minimize cable tension and cable slack are said to have “neutral bias.” Mechanisms that incorporate link systems with a neutral cable bias can generally retain their shape over a range of motion and resist counter forces applied against the mechanism that would compromise shape accuracy, and thus are generally preferred in most instances. However, depending on the application, negative or positive bias or effect can be advantageous. For example, in certain applications, negative cable bias, which introduces cable slack, may be desirable as it will decrease the rigidity of the articulated links, and limit their resistance to counter forces deployed along the links. Certain examples where this could be desirable include navigation of the links through or around sensitive or fragile anatomical structures. In other applications, positive cable bias, which introduces increased cable tension, may be desirable, as it will increase the rigidity of the articulated links and further their resistance to applied counter forces. Such tension can also provide resistance against further bending or articulation of the links. Examples where this could be desirable include applications where it is important to guard against too much bending or “overbending” of the link system.
Referring again to
When the links are manipulated into a desired position or configuration, each link of a link-bushing-link assembly pivots about its respective pivot point, such that any two adjacent links are pivoting toward or away from one another about dual pivot points. Further, as a result of such dual pivoting action for any given link, the distance a given cable channel exit point moves towards its corresponding cable channel exit point on an adjacent link is equal to the distance an opposing cable channel exit point on the opposite side of the link moves away from its corresponding cable channel exit point on the adjacent link. The combined distance between the two respective sets of cable channel exit points, however, remains constant whether or not the links are pivoted which is important to maintaining neutral cable bias. Where such combined distances are not equal, an increase in cable slack or tension can occur. Particularly, where the combined distance between sets of opposing channel exit points is greater when the links are pivoted or articulated as compared to the combined distance in the straight, non-articulated position, cable tension can occur. Alternatively, where the combined distance between sets of opposing channel exit points is lessened upon pivoting or articulation relative to a straight, non-articulated position, cable slack can occur.
This phenomena is illustrated more clearly with reference to
Link assembly 640 shown in
Link assembly 670 (
Neutral, negative, and positive cable bias can also be achieved in a variety of other link system conformations. By way of example and not limitation, the variation shown in
Another link-bushing-link assembly is shown
While particular embodiments of bushings have been described as having convex protrusions and/or concave depressions that are engaged with concave depressions and/or convex protrusions of corresponding links, bushings that are simply cylindrical and hollow with generally blunt ends are likewise useful. Such bushings will function equally well when engaged with the convex protrusions and/or concave depressions of the corresponding links, provided the inner diameter of the bushing is slightly smaller than the diameter of the corresponding convex protrusion, or alternatively the outer diameter of the bushing is slightly smaller than the corresponding concave depression, to allow for pivoting movement of the link relative to the bushing.
Consistent with the configurations and parameters otherwise discussed above, the links and bushings in the link systems and articulating mechanisms according to the invention may be of any size and shape, as the purpose dictates. For surgical applications, their form usually depends on such factors as patient age, anatomy of the region of interest, intended application, and surgeon preference. As noted, links and bushings are generally cylindrical, and may include channels for passage of the cables that connect links to other links or components of a device, as well as additional cables, wires, fiberoptics or other like elements associated with a desired tool or instrument used in conjunction with the link system. The channel diameters are usually slightly larger than the cable diameters, creating a slip fit. Further, the links may also include one or more channels for receiving elements of attachable surgical instruments or diagnostic tools or for passage of cables that actuate them. As noted, such channels can be located along the center or the periphery or at any radial location of the links or bushings. The links may typically have a diameter from about 0.5 mm to about 15 mm or more depending on the application. Bushings tend to have relatively comparable sizes to links, and frequently have a smaller diameter. For endoscopic applications, representative link diameters may range from about 2 mm to about 3 mm for small endoscopic instruments, about 5 mm to about 7 mm for mid-sized endoscopic instruments, and about 10 mm to about 15 mm for large endoscopic instruments. For catheter applications, the diameter may range from about 1 mm to about 5 mm. The overall length of the links and bushings will vary, usually depending on the bend radius desired between links.
For surgical applications, the links or bushings or other components of the mechanism or device into which the links or bushings are incorporated may be made from any biocompatible material including, but not limited to, stainless steel; titanium; tantalum; and any of their alloys; and polymers, e.g., polyethylene or copolymers thereof, polyethylene terephthalate or copolymers thereof, nylon, silicone, polyurethanes, fluoropolymers, poly (vinylchloride); and combinations thereof. A lubricious coating may be placed on the links or bushings or other components if desired to facilitate advancement of the link system. The lubricious coating may include hydrophilic polymers such as polyvinylpyrrolidone, fluoropolymers such as tetrafluoroethylene, or silicones. A radioopaque marker may also be included on one or more links or bushings to indicate the location of the articulating mechanism or device upon radiographic imaging. Usually, the marker will be detected by fluoroscopy.
Although the many link systems that have been illustrated in the accompanying figures have a certain number of links and bushings, this is solely for the illustrative purpose of indicating the relationship of the individual mechanism or link and bushing components to one another. Any number of links and bushings may be employed, depending on such factors as the intended use and desired length and range of movement of the articulating mechanism.
As noted, cables may be used to actuate the link systems of the invention. In such embodiments, one or more links are connected to its corresponding link or segment at the distal end by two or more cables. Each cable set may be made up of at least two cables. As noted, movement of one link is controlled by its corresponding cable set and is independent of any other link. In certain variations, for example, a cable set will include three cables. By using a set of three cables to connect to a link, the link can be manipulated or moved in three degrees of freedom (i.e., up/down motion, left/right motion, and rotational or “rolling” motion), independently of any other links. By combining a plurality of links, multiple degrees of freedom are achieved, allowing the link system to be shaped into various complex configurations. For example, the distal link set 106 shown in
Cable diameters vary according to the application, and may range from about 0.15 mm to about 3 mm. For catheter applications, a representative diameter may range from about 0.15 mm to about 0.75 mm. For endoscopic applications, a representative diameter may range from about 0.5 mm to about 3 mm.
Cable flexibility may be varied, for instance, by the type and weave of cable materials or by physical or chemical treatments. Usually, cable stiffness or flexibility will be modified according to that required by the intended application of the articulating mechanism. The cables may be individual or multi-stranded wires made from material, including but not limited to biocompatible materials such as nickel-titanium alloy, stainless steel or any of its alloys, superelastic alloys, carbon fibers, polymers, e.g., poly (vinylchloride), polyoxyethylene, polyethylene terephthalate and other polyesters, polyolefin, polypropylene, and copolymers thereof; nylon; silk; and combinations thereof, or other suitable materials known in the art.
The cables may be affixed to the links according to ways known in the art, such as by using an adhesive or by brazing, soldering, welding, and the like, including methods described in pending and co-owned U.S. application Ser. No. 10/444,769, incorporated herein by reference in its entirety. In the embodiment depicted in
Spacer links, i.e., links not connected by discrete sets of cables, may also be included in the link systems and articulating mechanisms of the invention. These links act as passive links that are not independently actuatable, but do allow for pass through of cable sets to neighboring active links. Spacer links can be desirable for providing additional length in a link system or articulating mechanism. In addition the inclusion of spacer links at one end of the mechanism allows for the proportional scaling of movement or motion of the corresponding other end. For example, the inclusion of spacer links at the proximal end of an articulating mechanism in which distal and proximal pairs of links are connected would require a more exaggerated movement by the user at the proximal end to achieve the desired motion at the distal end. This is advantageous in situations where fine, delicate controlled movements were desired, such as, for example, situations where there is a risk that a user may not possess the necessary dexterity to perform the desired procedure absent such proportional scaling of the distal end movement or motion. Alternatively, spacer links can be provided on the distal end, in which case the degree of distal end movements would be proportionally greater than those of the proximal end, which may also be desirable for particular applications. In addition to the above, proportional scaling of movement or motion can also be accomplished by increasing or decreasing the radius or distance that the cable channels are located from the center axis, as further described.
Turning to the embodiment of
In the embodiment shown in FIGS. 1 and 3-6, handle 110 is affixed to the proximal end of proximal link set 104. In this configuration, the handle itself can be used to manipulate the proximal links thereby resulting in corresponding manipulation of the distal links. Thus the handle itself can be used to manually manipulate and steer the distal end needle driver. In an alternative embodiment depicted in
The linking systems, articulating mechanisms, and devices incorporating such systems or mechanisms may also include a locking mechanism. When activated, the locking mechanism prevents one or more links or pairs of links from moving. In one aspect, the locking mechanism is configured to receive the cables (or other like actuating elements) that connect to and manipulate the links and, when activated, restrict cable (or other like actuating element) movement thereby restricting and locking corresponding connected link pairs. In certain variations, the locking mechanism includes moveable locking members and a fixed contact member, such that movement of the moveable locking members brings the cables (or other like actuating elements) into contact with the fixed contact member, impeding further movement of the cables (or other like actuating elements) and thereby also impeding movement of the links. The locking mechanism described are compatible with the links and link systems disclosed herein as well as other link systems, including those described e.g. in pending and co-owned U.S. application Ser. No. 10/444,769, incorporated herein by reference in its entirety, as well as other known link systems.
In the locked position, as depicted in
As seen most clearly in
The locking mechanism 400 is activated by moving the slider 410 in the along the axis of the locking mechanism 400.
In further embodiment of a locking mechanism according to the invention is depicted in
Locking mechanisms may be of any size and shape, as the purpose dictates, but their size and shape is typically similar to that of any associated link system, articulating mechanism, or device incorporating such systems or articulating mechanisms. Like the link systems themselves, the locking mechanisms are generally but need not be cylindrical, and may include channels for passage of the cables that connect the locking mechanism to other components of a device, as well as additional cables, wires, fiberoptics or other like elements associated with a desired tool or instrument used in conjunction with the locking mechanism. In embodiments of the locking mechanism that include cables, cable channel diameters are usually slightly larger than the cable diameters, creating a slip fit. Further, the locking mechanisms may also include one or more channels for receiving elements of attachable surgical instruments or diagnostic tools or for passage of cables that actuate them.
In some embodiments, a locking mechanism may be disposed on one end of a linking system or articulating mechanism. In other embodiments, the locking mechanism may be disposed at any position at the proximal or distal end of the surgical instrument. Although the many locking mechanisms that have been illustrated in the accompanying figures have certain configurations number components, this is solely for the illustrative purpose of indicating the relationship of the components to one another. Any number of components may be employed, depending on such factors as the intended use of the locking mechanism.
The invention also contemplates kits for providing various linking systems, articulating mechanisms, locking mechanisms, and associated accessories. For example, kits containing linking systems and articulating mechanisms having different lengths, different segment diameters, and/or different types of tools or instruments may be provided. The kits may optionally include different types of locking mechanisms. The kits may be further be tailored for specific applications. For example, kits for surgical applications can be configured for, e.g., endoscopy, retraction, or catheter placement, and/or for particular patient populations, e.g., pediatric or adult.
|Patente citada||Fecha de presentación||Fecha de publicación||Solicitante||Título|
|US443769||30 Dic 1890||Drive-chain|
|US1820463||30 Abr 1931||25 Ago 1931||Klein Otto G||Clinker tongs|
|US3060972||22 Ago 1957||30 Oct 1962||Bausch & Lomb||Flexible tube structures|
|US3071161||16 May 1960||1 Ene 1963||Bausch & Lomb||Bidirectionally flexible segmented tube|
|US3190286||31 Oct 1961||22 Jun 1965||Bausch & Lomb||Flexible viewing probe for endoscopic use|
|US3557780||16 Abr 1968||26 Ene 1971||Olympus Optical Co||Mechanism for controlling flexure of endoscope|
|US3605725||7 Ago 1968||20 Sep 1971||Medi Tech Inc||Controlled motion devices|
|US4466649||26 May 1982||21 Ago 1984||Tomy Kogyo Co., Inc.||Extendable hand amusement device|
|US4489826||5 Feb 1982||25 Dic 1984||Philip Dubson||Adjustable apparatus|
|US4580551||2 Nov 1984||8 Abr 1986||Warner-Lambert Technologies, Inc.||Flexible plastic tube for endoscopes and the like|
|US4700693||9 Dic 1985||20 Oct 1987||Welch Allyn, Inc.||Endoscope steering section|
|US4763669||4 Sep 1987||16 Ago 1988||Jaeger John C||Surgical instrument with adjustable angle of operation|
|US4790294||28 Jul 1987||13 Dic 1988||Welch Allyn, Inc.||Ball-and-socket bead endoscope steering section|
|US4834761||12 Ene 1987||30 May 1989||Walters David A||Robotic multiple-jointed digit control system|
|US4854626||26 Ene 1988||8 Ago 1989||Duke Roger S||Fish retrieving tool|
|US4880015||3 Jun 1988||14 Nov 1989||Nierman David M||Biopsy forceps|
|US4984951||22 Sep 1989||15 Ene 1991||The Board Of Trustees Of The Leland Stanford Junior University||Mechanical prehensor|
|US5174276||20 Nov 1989||29 Dic 1992||Hillway Surgical Limited||Endoscope device for applying an aneurysm clip|
|US5257618||6 Nov 1991||2 Nov 1993||Fuji Photo Optical Co., Ltd.||Endoscope|
|US5271381||18 Nov 1991||21 Dic 1993||Vision Sciences, Inc.||Vertebrae for a bending section of an endoscope|
|US5273026||6 Mar 1992||28 Dic 1993||Wilk Peter J||Retractor and associated method for use in laparoscopic surgery|
|US5286228||23 Nov 1992||15 Feb 1994||C. J. Associates, Ltd.||Toy mechanical hand|
|US5297443||7 Jul 1992||29 Mar 1994||Wentz John D||Flexible positioning appendage|
|US5314424||6 Abr 1992||24 May 1994||United States Surgical Corporation||Surgical instrument locking mechanism|
|US5322064||24 Sep 1993||21 Jun 1994||Lundquist Ingemar H||Torquable catheter and method|
|US5325845||8 Jun 1992||5 Jul 1994||Adair Edwin Lloyd||Steerable sheath for use with selected removable optical catheter|
|US5330502||9 Oct 1992||19 Jul 1994||Ethicon, Inc.||Rotational endoscopic mechanism with jointed drive mechanism|
|US5354162||31 Ago 1992||11 Oct 1994||Rutgers University||Actuator system for providing force feedback to portable master support|
|US5381782||23 Feb 1993||17 Ene 1995||Spectrum Medsystems Corporation||Bi-directional and multi-directional miniscopes|
|US5403342||21 Jun 1993||4 Abr 1995||United States Surgical Corporation||Articulating endoscopic surgical apparatus|
|US5405344||30 Sep 1993||11 Abr 1995||Ethicon, Inc.||Articulable socket joint assembly for an endoscopic instrument for surgical fastner track therefor|
|US5425743||19 Oct 1993||20 Jun 1995||United States Surgical Corporation||Surgical instrument locking mechanism|
|US5441494||29 Jul 1993||15 Ago 1995||Ethicon, Inc.||Manipulable hand for laparoscopy|
|US5454827||24 May 1994||3 Oct 1995||Aust; Gilbert M.||Surgical instrument|
|US5476479||11 Ene 1995||19 Dic 1995||United States Surgical Corporation||Handle for endoscopic surgical instruments and jaw structure|
|US5486154||8 Jun 1993||23 Ene 1996||Kelleher; Brian S.||Endoscope|
|US5490819||2 Sep 1994||13 Feb 1996||United States Surgical Corporation||Articulating endoscopic surgical apparatus|
|US5498256||28 May 1993||12 Mar 1996||Snowden-Pencer, Inc.||Surgical instrument handle|
|US5513827||26 Jul 1993||7 May 1996||Karlin Technology, Inc.||Gooseneck surgical instrument holder|
|US5520678||30 Nov 1994||28 May 1996||Richard Wolf Gmbh||Manipulator arm with proximal and distal control balls|
|US5522788||26 Oct 1994||4 Jun 1996||Kuzmak; Lubomyr I.||Finger-like laparoscopic blunt dissector device|
|US5549636||5 Oct 1994||27 Ago 1996||Li Medical Technologies Inc.||Surgical grasper with articulated fingers|
|US5562699||30 Mar 1995||8 Oct 1996||Richard Wolf Gmbh||Forceps|
|US5570919||26 Jun 1995||5 Nov 1996||Eusebe; Frantz-Lee||Remote grapple|
|US5599151||4 Mar 1994||4 Feb 1997||Daum Gmbh||Surgical manipulator|
|US5609601||23 Sep 1994||11 Mar 1997||United States Surgical Corporation||Endoscopic surgical apparatus with rotation lock|
|US5620415||23 Sep 1994||15 Abr 1997||Smith & Dyonics, Inc.||Surgical instrument|
|US5624398||8 Feb 1996||29 Abr 1997||Symbiosis Corporation||Endoscopic robotic surgical tools and methods|
|US5626608||29 Mar 1996||6 May 1997||United States Surgical Corporation||Surgical instrument having locking handle|
|US5632432||19 Dic 1994||27 May 1997||Ethicon Endo-Surgery, Inc.||Surgical instrument|
|US5643294||28 Mar 1996||1 Jul 1997||United States Surgical Corporation||Surgical apparatus having an increased range of operability|
|US5647743||11 May 1994||15 Jul 1997||Schmitt; Friedrich||Device for treating jaw fractures or tooth displacements|
|US5702408||17 Jul 1996||30 Dic 1997||Ethicon Endo-Surgery, Inc.||Articulating surgical instrument|
|US5704534||30 Sep 1996||6 Ene 1998||Ethicon Endo-Surgery, Inc.||Articulation assembly for surgical instruments|
|US5713505||13 May 1996||3 Feb 1998||Ethicon Endo-Surgery, Inc.||Articulation transmission mechanism for surgical instruments|
|US5716352||29 Abr 1996||10 Feb 1998||United States Surgical Corporation||Apparatus and method for performing surgical tasks during laparoscopic procedures|
|US5759151||7 Jun 1995||2 Jun 1998||Carnegie Mellon University||Flexible steerable device for conducting exploratory procedures|
|US5762067 *||30 May 1996||9 Jun 1998||Advanced Technology Laboratories, Inc.||Ultrasonic endoscopic probe|
|US5792164||19 Dic 1994||11 Ago 1998||Lakatos; Nick||Surgical instrument|
|US5807376||25 Abr 1995||15 Sep 1998||United States Surgical Corporation||Apparatus and method for performing surgical tasks during laparoscopic procedures|
|US5813813||3 Nov 1997||29 Sep 1998||Daum Gmbh||Surgical manipulator|
|US5823066||13 May 1996||20 Oct 1998||Ethicon Endo-Surgery, Inc.||Articulation transmission mechanism for surgical instruments|
|US5827323||4 Oct 1996||27 Oct 1998||Charles H. Klieman||Surgical instrument for endoscopic and general surgery|
|US5836960||24 Feb 1997||17 Nov 1998||United States Surgical Corporation||Endoscopic surgical apparatus with rotation lock|
|US5845540||25 Sep 1997||8 Dic 1998||Ross-Hime Designs, Incorporated||Robotic manipulator|
|US5846183||7 Jul 1997||8 Dic 1998||Chilcoat; Robert T.||Articulated endoscope with specific advantages for laryngoscopy|
|US5873817||12 May 1997||23 Feb 1999||Circon Corporation||Endoscope with resilient deflectable section|
|US5899425||1 May 1998||4 May 1999||Medtronic, Inc.||Adjustable supporting bracket having plural ball and socket joints|
|US5916146||18 Dic 1996||29 Jun 1999||Bieffe Medital S.P.A.||System for support and actuation with vertebrae in particular for surgical and diagnostic instruments|
|US5916147||22 Sep 1997||29 Jun 1999||Boury; Harb N.||Selectively manipulable catheter|
|US5921956||24 Sep 1997||13 Jul 1999||Smith & Nephew, Inc.||Surgical instrument|
|US5938678||11 Jun 1997||17 Ago 1999||Endius Incorporated||Surgical instrument|
|US5947984||10 Oct 1997||7 Sep 1999||Ethicon Endo-Surger, Inc.||Ultrasonic clamp coagulator apparatus having force limiting clamping mechanism|
|US5961532||29 Ago 1997||5 Oct 1999||Stryker Corporation||Surgical tool having flexible tubular inner member movable for tissue working|
|US6019722||17 Sep 1997||1 Feb 2000||Guidant Corporation||Device to permit offpump beating heart coronary bypass surgery|
|US6050996||12 Nov 1997||18 Abr 2000||Sherwood Services Ag||Bipolar electrosurgical instrument with replaceable electrodes|
|US6161543||15 Oct 1997||19 Dic 2000||Epicor, Inc.||Methods of epicardial ablation for creating a lesion around the pulmonary veins|
|US6250532||19 Ene 2000||26 Jun 2001||United States Surgical Corporation||Surgical stapling apparatus|
|US6270453||27 Dic 1999||7 Ago 2001||Suzuki Motor Corporation||Bending device for examining insertion tube|
|US6446850||22 Feb 2001||10 Sep 2002||Formosa Saint Jose, Corp.||Luggage rack on car roof|
|US6464704||20 Jun 2001||15 Oct 2002||Sherwood Services Ag||Bipolar electrosurgical instrument with replaceable electrodes|
|US6471641||22 Mar 2001||29 Oct 2002||Fuji Photo Optical Co., Ltd.||Joint construction for connecting an angle section to a flexible body section of endoscopic insertion instrument|
|US6471696||12 Abr 2000||29 Oct 2002||Afx, Inc.||Microwave ablation instrument with a directional radiation pattern|
|US6482149||11 May 2000||19 Nov 2002||Fuji Photo Optical Co., Ltd.||Curved part of endoscope|
|US6491626||13 Abr 2000||10 Dic 2002||Nuvasive||Articulation systems for positioning minimally invasive surgical tools|
|US6571042||26 Sep 2000||27 May 2003||Tyco Telecommunications (Us) Inc.||Multi-body modular repeater system and articulated housing for use therewith|
|US6626824||16 May 2001||30 Sep 2003||Storz Endoskop Gmbh||Exchangeable tool assembly for an endoscopic treatment device and such treatment device|
|US6635071||24 Ago 2001||21 Oct 2003||Karl Storz Gmbh & Co. Kg||Surgical grasping and holding forceps|
|US6638213||2 Oct 2001||28 Oct 2003||Olympus Optical Co., Ltd.||Endoscope|
|US6638287||7 Dic 2001||28 Oct 2003||Novare Surgical Systems||Clamp having bendable shaft|
|US6641528||6 Sep 2001||4 Nov 2003||Fuji Photo Optical Co., Ltd.||Bending part of endoscope|
|US6644532||9 May 2001||11 Nov 2003||United States Surtical Corporation||Surgical stapling apparatus|
|US6666854||23 Jun 2000||23 Dic 2003||La Precision||Endoscopic surgical instrument|
|US6669254||12 Abr 2002||30 Dic 2003||Bel-Art Products, Inc.||Manual pick-up device|
|US6676676||1 May 2002||13 Ene 2004||Novare Surgical Systems||Clamp having bendable shaft|
|US6682541||16 Sep 2002||27 Ene 2004||Gifford, Iii Hanson S.||Devices and methods for performing a vascular anastomosis|
|US6743239||25 May 2000||1 Jun 2004||St. Jude Medical, Inc.||Devices with a bendable tip for medical procedures|
|US6746443||27 Jul 2000||8 Jun 2004||Intuitive Surgical Inc.||Roll-pitch-roll surgical tool|
|US6749560||26 Oct 1999||15 Jun 2004||Circon Corporation||Endoscope shaft with slotted tube|
|US6752823||1 Mar 2002||22 Jun 2004||Richard Wolf Gmbh||Surgical forceps|
|US6764445||14 Dic 2001||20 Jul 2004||Intuitive Surgical, Inc.||Stabilizer for robotic beating-heart surgery|
|US6773327||12 Feb 2002||10 Ago 2004||Hasbro, Inc.||Apparatus for actuating a toy|
|US6817972||29 May 2001||16 Nov 2004||Computer Motion, Inc.||Heart stabilizer|
|US6824548||6 Dic 2001||30 Nov 2004||Ethicon Endo-Surgery, Inc.||Flexible surgical clip applier|
|US6843794||6 Dic 2001||18 Ene 2005||Ethicon Endo-Surgery, Inc.||Surgical clip applier having jaws adapted to guide and deform a clip|
|US6858005||27 Ago 2002||22 Feb 2005||Neo Guide Systems, Inc.||Tendon-driven endoscope and methods of insertion|
|US6902560||6 Ene 2004||7 Jun 2005||Intuitive Surgical, Inc.||Roll-pitch-roll surgical tool|
|US6942613||25 Oct 2002||13 Sep 2005||Usgi Medical Inc.||Shape lockable apparatus and method for advancing an instrument through unsupported anatomy|
|US6945979||6 Dic 2001||20 Sep 2005||Ethicon Endo-Surgery, Inc.||Surgical device having a handle adapted to impart tensile and compressive forces to elements at a distal end of the device|
|US6960162||25 Oct 2002||1 Nov 2005||Usgi Medical Inc.||Shape lockable apparatus and method for advancing an instrument through unsupported anatomy|
|US6960163||25 Oct 2002||1 Nov 2005||Usgi Medical Inc.||Shape lockable apparatus and method for advancing an instrument through unsupported anatomy|
|US6976969||14 Ene 2002||20 Dic 2005||Ethicon Endo-Surgery, Inc.||Blades with functional balance asymmetries for use with ultrasonic surgical instruments|
|US6994700||18 Mar 2005||7 Feb 2006||Flowmedica, Inc.||Apparatus and method for inserting an intra-aorta catheter through a delivery sheath|
|US7090637||23 May 2003||15 Ago 2006||Novare Surgical Systems, Inc.||Articulating mechanism for remote manipulation of a surgical or diagnostic tool|
|US7138976||13 Jul 2000||21 Nov 2006||Rutgers, The State University Of New Jersey||Hand force feedback and sensing system|
|US7410483||24 Nov 2004||12 Ago 2008||Novare Surgical Systems, Inc.||Hand-actuated device for remote manipulation of a grasping tool|
|US7480600||16 Nov 2004||20 Ene 2009||The Massachusetts Institute Of Technology||Force reflecting haptic interface|
|US7615066||13 Jul 2005||10 Nov 2009||Novare Surgical Systems, Inc.||Articulating mechanism for remote manipulation of a surgical or diagnostic tool|
|US7678117||24 Sep 2004||16 Mar 2010||Novare Surgical Systems, Inc.||Articulating mechanism with flex-hinged links|
|US7682307||9 Nov 2005||23 Mar 2010||Novare Surgical Systems, Inc.||Articulating mechanism for remote manipulation of a surgical or diagnostic tool|
|US7828808||26 Ago 2004||9 Nov 2010||Novare Surgical Systems, Inc.||Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools|
|US8323297||16 Mar 2010||4 Dic 2012||Intuitive Surgical Operations, Inc.||Articulating mechanism with flex-hinged links|
|US8419747||15 Jun 2010||16 Abr 2013||Intuitive Surgical Operations, Inc.||Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools|
|US20010023313||2 Feb 2001||20 Sep 2001||Fuji Photo Optical Co. Ltd.||Insertion instrument of an endoscope|
|US20010042766||22 Feb 2001||22 Nov 2001||Yang Ming-Shun||Luggage rack on car roof|
|US20020096177||4 Abr 2002||25 Jul 2002||Toti Andrew J.||Endotracheal tube with tip directional control and position preserving mechanism|
|US20020111604||18 Jul 2001||15 Ago 2002||Doyle Mark C.||Hand-actuated articulating surgical tool|
|US20020156497||17 Abr 2002||24 Oct 2002||Olympus Optical Co., Ltd.||Surgical instrument|
|US20020161281||2 May 2002||31 Oct 2002||Ross Jaffe||Endoscope having a guide tube|
|US20020177750||8 Ene 2002||28 Nov 2002||Tonis Pilvisto||Endoscope-type device, particularly for emergency intubation|
|US20030036748||28 Jun 2002||20 Feb 2003||Intuitive Surgical, Inc.||Surgical tool having positively positionable tendon-actuated multi-disk wrist joint|
|US20030050649||16 Nov 2001||13 Mar 2003||Brock David L.||Surgical instrument|
|US20030078644||22 Oct 2001||24 Abr 2003||Phan Huy D.||Apparatus for supporting diagnostic and therapeutic elements in contact with tissue including electrode cooling device|
|US20030109898||15 Ene 2003||12 Jun 2003||Tuebingen Scientific Surgical Products Ohg||Surgical instrument for minimally invasive surgical interventions|
|US20030114838||14 Dic 2001||19 Jun 2003||O'neill William G.||Apparatus and method for performing surgery on a patient|
|US20030135204||18 Nov 2002||17 Jul 2003||Endo Via Medical, Inc.||Robotically controlled medical instrument with a flexible section|
|US20030149338||21 Oct 2002||7 Ago 2003||Christian Francois||Positioning, exploration, and/or intervention device, in particular in the field of endoscopy and/or mini-invasive surgery|
|US20030153902||13 Mar 2003||14 Ago 2003||Doyle Mark C.||Hand-actuated articulating surgical tool|
|US20030229271||6 Jun 2002||11 Dic 2003||Medtronic, Inc.||Surgical tool for engagement of body tissue|
|US20030233026||13 Jun 2002||18 Dic 2003||Vahid Saadat||Shape lockable apparatus and method for advancing an instrument through unsupported anatomy|
|US20040054322||12 Sep 2003||18 Mar 2004||Vargas Jaime Salvador||Shape-transferring cannula system and method of use|
|US20040138529||9 Jun 2003||15 Jul 2004||Usgi Medical Corp.||Endoluminal tool deployment system|
|US20040138700||2 Dic 2003||15 Jul 2004||Intuitive Surgical, Inc.||Flexible wrist for surgical tool|
|US20040236316||23 May 2003||25 Nov 2004||Danitz David J.||Articulating mechanism for remote manipulation of a surgical or diagnostic tool|
|US20050090809||1 Nov 2004||28 Abr 2005||Intuitive Surgical, Inc.||Surgical tool having positively positionable tendon-actuated multi-disk wrist joint|
|US20050096694||12 Abr 2004||5 May 2005||Woojin Lee||Surgical instrument|
|US20050107667||24 Nov 2004||19 May 2005||Novare Surgical Systems, Inc.||Hand-actuated device for remote manipulation of a grasping tool|
|US20050119527||30 Sep 2004||2 Jun 2005||Scimed Life Systems, Inc.||Force feedback control system for video endoscope|
|US20050251112||13 Jul 2005||10 Nov 2005||Danitz David J||Articulating mechanism for remote manipulation of a surgical or diagnostic tool|
|US20050273084||26 Ago 2004||8 Dic 2005||Novare Surgical Systems, Inc.||Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools|
|US20050273085||24 Sep 2004||8 Dic 2005||Novare Surgical Systems, Inc.||Articulating mechanism with flex-hinged links|
|US20060009759||2 Jun 2005||12 Ene 2006||Chrisitian Steven C||Loop ablation apparatus and method|
|US20060020287||20 Jul 2005||26 Ene 2006||Woojin Lee||Surgical instrument|
|US20060058582||28 Sep 2005||16 Mar 2006||Usgi Medical Inc.||Disposable shapelocking system|
|US20060094931||9 Nov 2005||4 May 2006||Novare Surgical Systems, Inc.||Articulating mechanism for remote manipulation of a surgical or diagnostic tool|
|US20060111209||23 Nov 2004||25 May 2006||Novare Surgical Systems, Inc.||Articulating mechanisms and link systems with torque transmission in remote manipulation of instruments and tools|
|US20060111210||4 May 2005||25 May 2006||Novare Surgical Systems, Inc.||Articulating mechanisms and link systems with torque transmission in remote manipulation of instruments and tools|
|US20060111615||23 Nov 2004||25 May 2006||Novare Surgical Systems, Inc.||Articulating sheath for flexible instruments|
|US20060111616||3 May 2005||25 May 2006||Novare Surgical Systems, Inc.||Articulating mechanism components and system for easy assembly and disassembly|
|US20060199999||2 Mar 2006||7 Sep 2006||Intuitive Surgical Inc.||Cardiac tissue ablation instrument with flexible wrist|
|US20060201130||30 Ene 2006||14 Sep 2006||Danitz David J||Articulating mechanisms with joint assembly and manual handle for remote manipulation of instruments and tools|
|US20070250113||16 Abr 2007||25 Oct 2007||Hegeman David E||Tool with articulation lock|
|US20070287993||16 Abr 2007||13 Dic 2007||Hinman Cameron D||Tool with rotation lock|
|US20080255421||16 Abr 2007||16 Oct 2008||David Elias Hegeman||Articulating tool with improved tension member system|
|US20080255588||16 Abr 2007||16 Oct 2008||Hinman Cameron D||Tool with multi-state ratcheted end effector|
|US20080255608||16 Abr 2007||16 Oct 2008||Hinman Cameron D||Tool with end effector force limiter|
|US20080262538||24 Abr 2008||23 Oct 2008||Novare Surgical Systems, Inc.||Articulating instrument|
|US20100041945||17 Ago 2009||18 Feb 2010||Isbell Jr Lewis||Instrument with articulation lock|
|US20130060239||2 Nov 2012||7 Mar 2013||Intuitive Surgical Operations, Inc.||Articulating mechanism with flex hinged links|
|USRE38335||28 Mar 2000||25 Nov 2003||Endius Incorporated||Surgical instrument|
|EP0165718A2||21 May 1985||27 Dic 1985||Pilkington Medical Systems Limited (formely Minvade Limited)||Endoscopes|
|EP0598618A2||18 Nov 1993||25 May 1994||Ethicon Inc.||Intraluminal manipulator|
|EP0836833A2||13 Oct 1997||22 Abr 1998||Bristol-Myers Squibb Company||Rotatable surgical burr|
|EP0836833A3||13 Oct 1997||9 Dic 1998||Linvatec Corporation||Rotatable surgical burr|
|EP1132041A2||5 Mar 2001||12 Sep 2001||STM Medizintechnik Starnberg GmbH||Endoscope shaft|
|EP1395398A1||12 Jun 2002||10 Mar 2004||Oliver Crispin Robotics Limited||Link assembly for a snake like robot arm|
|EP1395398B1||12 Jun 2002||4 Ene 2006||Oliver Crispin Robotics Limited||Link assembly for a snake like robot arm|
|JP6262549A||Título no disponible|
|JP2001299768A||Título no disponible|
|WO1998049961A1||8 May 1997||12 Nov 1998||Mullane Thomas S||Articulating toggle bolt bone screw|
|WO2001010292A1||26 Jul 2000||15 Feb 2001||Technische Universiteit Delft||Endoscope|
|WO2001097694A1||15 Jun 2001||27 Dic 2001||Intuitive Surgical, Inc.||Guided tool change|
|WO2002013682A1||19 Jul 2001||21 Feb 2002||Technische Universiteit Delft||Spring and endoscope equipped with such a spring|
|WO2004019769A1||27 Ago 2003||11 Mar 2004||Neoguide Systems, Inc.||Tendon-dirven endoscope and methods of insertion|
|WO2004105578A2||21 May 2004||9 Dic 2004||Novare Surgical Systems, Inc.||Articulating mechanism for remote manipulation of a surgical or diagnostic tool|
|WO2005067785A1||5 Ene 2005||28 Jul 2005||Technische Universiteit Delft||Instrument for fine-mechanical or surgical applications|
|WO2005120326A2||23 May 2005||22 Dic 2005||Novare Surgical Systems, Inc.||Articulating mechanism with flex-hinged links|
|WO2005120327A2||23 May 2005||22 Dic 2005||Novare Surgical Systems, Inc.||Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools|
|WO2005120327A3||23 May 2005||2 Mar 2006||Novare Surgical Systems Inc||Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools|
|WO2006057699A1||15 Sep 2005||1 Jun 2006||Novare Surgical Systems, Inc.||Articulating mechanism comprising pairs of link components connected by cables and which can be easily assembled|
|WO2006057700A1||15 Sep 2005||1 Jun 2006||Novare Surgical Systems, Inc.||Articulating sheath for flexible instruments|
|WO2006057702A3||19 Sep 2005||20 Jul 2006||Novare Surgical Systems Inc||Hand-actuated device for remote manipulation of a grasping tool|
|WO2006073581A8||18 Nov 2005||21 Jun 2007||David J Danitz||Articulating mechanisms and link systems with torque transmission in remote manipulation of instruments and tools|
|1||Cox J., "The minimally invasive Maze-III procedure; Operative Techniques in Thoracic and Cardiovascular Surgery," 2000, vol. 5, Issue 1, pp. 79-92.|
|2||Danitz et al.; U.S. Appl. No. 12/109,333 entitled "Articulating instrument," filed Apr. 24, 2008.|
|3||Danitz et al.; U.S. Appl. No. 12/766,818 entitled "Articulating instruments with joystick control," filed Apr. 23, 2010.|
|4||Danitz, David J., U.S. Appl. No. 11/344,465, filed Jan. 30, 2006, 28 pages.|
|5||Danitz, David J.; U.S. Appl. No. 12/766,820 entitled "Articulating mechanism with bifurcating control," filed Apr. 23, 2010.|
|6||Danitz, David J.; U.S. Appl. No. 12/766,822 entitled "Articulating catheters," filed Apr. 23, 2010.|
|7||Danitz, David J.; U.S. Appl. No. 12/766,825 entitled "Articulating endoscopes," filed Apr. 23, 2010.|
|8||Danitz, David J.; U.S. Appl. No. 12/766,827 entitled "Articulating retractors," filed Apr. 23, 2010.|
|9||Extended European Search Report for Application No. EP13156020, mailed on Apr. 29, 2013, 6 pages.|
|10||Hegeman et al; U.S. Appl. No. 11/787,543 entitled "Tool with articulation lock," filed Apr. 16, 2007 (SLG# 10112-701.502).|
|11||Hegeman et al; U.S. Appl. No. 11/787,608 entitled "Articulating tool with improved tension member system" filed Apr. 16, 2007 (SLG# 10112-705.201).|
|12||Hinman et al.; U.S. Appl. No. 12/725,377 entitled "Articulating mechanism with flex-hinged links," filed Mar. 16, 2010.|
|13||Hinman et al; U.S. Appl. No. 11/787,599 entitled "Tool with end effector force limiter," filed Apr. 16, 2007 (SLG# 10112-704.201).|
|14||Hinman, Cameron; U.S. Appl. No. 11/787,605 entitled "Tool with multi-state ratcheted end effector," filed Apr. 16, 2007 (SLG# 10112-703201).|
|15||Hinman, Cameron; U.S. Appl. No. 11/787,607 entitled "Tool with rotation lock," filed Apr. 16, 2007 (SLG# 10112-702.201).|
|16||Hinman, Cameron; U.S. Appl. No. 12/508,478 entitled "Articulating mechanism," filed Jul. 23, 2009.|
|17||International Search Report for Application No. PCT/US2005/018145 (WO2005120326), mailed on Feb. 20, 2006, 5 pages.|
|18||Isbell, Jr., Lewis; U.S. Appl. No. 12/542,589 entitled "Instrument with articulation lock," filed Aug. 17, 2009.|
|19||Prasad et al., "Epicardial ablation on the beating heart: progress towards an off-pump maze procedure," The Heart Surgery Forum, 2001, vol. 5, Issue 2, pp. 100-104.|
|20||Simha et al., "The elctrocautery maze-how I do it," The Heart Surgery Forum, 2001, vol. 4, Issue 4, pp. 340-345.|
|21||Simha et al., "The elctrocautery maze—how I do it," The Heart Surgery Forum, 2001, vol. 4, Issue 4, pp. 340-345.|
|22||U.S. Appl. No. 10/948,911, filed Sep. 24, 2004 for Danitz et al., 52 pages.|
|23||U.S. Appl. No. 10/997,372, filed Nov. 23, 2004 for Danitz et al., 78 pages.|
|24||Vertut, Jean and Phillipe Coiffet, Robot Technology: Teleoperation and Robotics Evolution and Development, English translation, Prentice-Hall, Inc., Inglewood Cliffs, NJ, USA 1986, vol. 3A, 332 pages.|
|25||Written Opinion for Application No. PCT/US2005/018145, mailed on Feb. 20, 2006, 7 pages.|
|Patente citante||Fecha de presentación||Fecha de publicación||Solicitante||Título|
|US9517326||5 Dic 2014||13 Dic 2016||Intuitive Surgical Operations, Inc.||Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools|
|Clasificación de EE.UU.||606/108|
|Clasificación internacional||B25J1/02, A61B19/00, A61B17/29, A61B1/005, A61B17/28, A61B17/00, A61B17/072, A61B1/008, A61M25/01|
|Clasificación cooperativa||A61B90/11, A61M25/0147, A61B1/008, A61B17/00, A61B2017/00323, A61B17/29, A61B2017/00327, A61B1/0051, A61B2017/294, A61B2017/292, A61B2017/003, A61M25/0138, A61B2017/2902, A61B2017/291, A61B2017/2927|